Drawing the Curtain Back on Injured Commercial Bicyclists

Objectives. We determined the demographic characteristics, behaviors, injuries, and outcomes of commercial bicyclists who were injured while navigating New York City’s (NYC’s) central business district.Methods. Our study involved a secondary analysis of prospectively collected data from a level 1 regional trauma center in 2008 to 2014 of bicyclists struck by motor vehicles. We performed univariable and multivariable logistic regression analyses.Results. Of 819 injured bicyclists, 284 (34.7%) were working. Commercial bicyclists included 24.4% to 45.1% of injured bicyclists annually. Injured commercial bicyclists were more likely Latino (56.7%; 95% confidence interval CI] = 50.7, 62.8 vs 22.7%; 95% CI = 19.2, 26.5). Commercial bicyclists were less likely to be distracted by electronic devices (5.0%; 95% CI = 2.7, 8.2 vs 12.7%; 95% CI = 9.9, 15.9) or to have consumed alcohol (0.7%; 95% CI = 0.9, 2.5 vs 9.5%; 95% CI = 7.2, 12.3). Commercial and noncommercial bicyclists did not differ in helmet use (38.4%; 95% CI = 32.7, 44.4 vs 30.8%; 95% CI = 26.9, 34.9). Injury severity scores were less severe in commercial bicyclists (odds ratio = 0.412; 95% CI = 0.235, 0.723).Conclusions. Commercial bicyclists represent a unique cohort of vulnerable roadway users. In NYC, minorities, especially Latinos, should be targeted for safety education programs.In the United States in 2012, 726 bicyclists were killed and 49 000 were injured in motor vehicle collisions1–3; these fatalities accounted for 2.2% of motor vehicle–related deaths, but represented a 6.5% increase from 2011.1,2 In New York City (NYC), there were 4207 bicycle collisions in 2012 that resulted in injury, including 20 fatalities.4An estimated 185 000 people bike in NYC daily; of these, 5000 are commercial bicyclists making deliveries.5 Although commercial bicyclists include only 2.7% of bicyclists in NYC, they account for 16% of daily bicycle trips, at an average of 22 trips per day per commercial bicyclist.5 There are an estimated 109 375 food delivery trips made daily across NYC, covering 100 000 miles.5 NYC businesses have been required to provide employee bicyclists with helmets and safety gear, including reflectors, since 2007 and identification cards and reflective vests since 2013.6–9 Following a 10-month safety education initiative for business owners, the NYC Department of Transportation (DOT) increased enforcement of existing commercial bicycling safety laws in April 2013 by deploying inspectors to businesses to issue violations for missing or improper safety equipment and nonadherence to mandatory safety courses.10–12Commercial bicyclists represent a unique population whose characteristics, behaviors, and injuries have not been previously documented. A comprehensive literature search yielded only 3 articles13–15 relevant to the subject matter, emphasizing the need for more data on this population. Furthermore, current New York State and City databases do not identify injured bicyclists as commercial or noncommercial.1,4 Previous work from our trauma center revealed that 43% of injured bicyclists involved in motor vehicle collisions were commercial.16,17 Although commercial bicyclists provide a convenient service in many urban centers, essential information regarding their safety practices, behaviors, and outcomes in the event of injury is lacking. Our hypothesis was that commercial bicyclists represent a distinct cohort of vulnerable roadway users with a high minority representation. The objective of this study was to describe the demographic characteristics, behaviors, injuries, and outcomes of commercial bicyclists who were injured while navigating NYC’s central business district.